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Other than my first solo horse-packing trip into the Cascades and
living through a host of learning experiences, I have seldom
learned so much in one week as during my stay at Northwoods, a five
star rehab center just north of Silverdale.

I hope to progress as I should, working out at home and/or in a
commercial pool. The
primary goal here is to rebuild the muscling around my arthritic
bone on bone left hip in order to pedal a recumbent
trike.

One of Northwoods rehab specialist, Jeff, actually got me RUNNING
in the chest high water, coming down on my left foot without the
old debilitating pain…muscle building safely in the
water.

Incidentally, the second time I ran in the water I felt so Tarzana
that when Jeff asked me to sit on the water stool for a series of
other exercises; I made a surprising running leap for it… and
slammed into it or would have if I’d got that far.

I began the jump too far out and the side effect was a gut
wrenching, breathtaking laugh – so hard I ran out of air and had to
focus hard to stop laughing. COPD is not for sissies – nor
are fancied, imagined, graceful gazelle leaps of joy that I could
put weight on that left hip.

Good Physical Therapists cause little moments of joy for the
patients they guide into better fitness as we work into better
health.

Northwoods has many good or great physical therapists – I am
talking a little about some of the people and my latest experience
as a patient in one of two Kitsap County five-star rehab
centers.

For information, I didn’t qualify for insurance coverage since I
had only been at Harrison overnight for observation, yet encouraged
by Harrison’s sharp good-by, good luck doctor,Dr.
Mathew Coates the next day, I decided to give it a couple
days…and stayed over a week.

This is the entrance to the Red Barn dining room leading to access
to the salty rehab pool.

Antiques – some early Kitsap County settler and his family plowed
ground with this nifty tool and a couple good horses – or, maybe it
is a thresher – a hay cutter.

Note the wonderful old artifacts displayed everywhere in the “red
barn “ – take a gander at the two-woman saw on the wall
above the staircase.

Open for dining

These wonderful items are displayed on the way to the ladies
changing room and the pool.

On my way out, dinner guests coming in…hubby waiting for me to go
home Gorgeous
quilts on the upper, left wall

Door to the pool

Roomy shower – kept spotless

The first dressing room/ladies room leading to
a pool that I have seen decorated with real hand-worked framed
quilt squares on the wall.

Kristi, left, following Jeff’s exercise plan had me run as fast as
I could to the end of the pool – stop and walk backwards to the
other end and repeat the run…got me laughing when I spotted her
‘running’ alongside.
She moved through the water like a prancing parade horse – head
bobbing, smooth and graceful while I plowed through the water using
my arms pulling forward – feeling plow horsey running through the
deliciously warm water. Kristi asked why I was
laughing. Her first
time running through water, she said, when I told her. She has a wonderful spirit and I
howled…and did not tell her Jeff saved his energy and did not run
alongside when he instructed me to run.

Patients need the lightness of spirit and humor with the serious
work they do helping put us together again,…we’re
sort of like HumptyDumpty
and they help us get back together again and teach us how to apply
our own glue.Kristi and Shayla

Thanks Shayla, (PT) and Kristi (PTA) – What a great job you do for
us!

Tsaristic stuff happens, “we don’t live in a perfect world” a young
nurse recently told me when I questioned the hospital discharge
papers. Used to
transparency and kind consideration – I had expected better – much
better.

The following was copied verbatim with permission of Thor
Dahl. The
place is Florida – not here – but we need to be aware that Mr. Dahl
and his wife are credible established people and business folks
running the largest international online rosemaling “club’
offered….and where I read the following shocking post. It was a reminder – patient,
friends and family – be aware – stuff happens.

28 March 2013 – The Global Rosemaling Club:

“Yesterday we went to
my surgeon for the third visit since my surgery last December 20th.
I also had my first “commercial” haircut in over a year. But Joan
has been nice trimming it several times. She used to do a great
job! I also drove the car for the first time. Joan drove home. But
I was happy to feel that I could handle the car after more than a
year as a passenger.

The doctor didn’t give us the kind of news that I had hoped for.
Each time I go there, they take a few x-rays to see how I’m
healing. He said that due to the first hospital I went to let me
out without knowing that I had 2 breaks in my back, the 6 extra
months it took to find this out before the final surgery in a much
better hospital, was too long to straighten out my old spine. So
I’ll be living with an ugly hump and pain for the rest of my life.
As well as not being able to lift more than 25 pounds while being
very carefully without bending too much. If I was too ruff with my
back, it just could brake again. He was very liberal on giving me
prescriptions for pain medicine and indicated that I should not be
afraid of taking them. From next Monday, I’ll start going to their
“in house” physical treatment department. It will be from 2 to 3
times a week depending on what they think will be best for me. The
doctor assured me that I could get anything I asked him for. I
guess he felt sorry for the way this turned out for me.

He clearly admitted it was due to the poor treatment from my first
hospital and added that this was not the first time they had failed
with their surgery or diagnoses at that hospital. So he will
hopefully be a good witness, because being ruined for the few years
I have left, somebody should pay for not giving me the proper
treatment. This will include the arthritis dr. that gave me the
wrong medicine, which gave me internal bleeding and
fainting.

Even with all the above negative “news”, I feel a lot better
despite it’s going to be hard to get used to having an ugly hump on
my back!

However, I feel so badly for Joan who will be stuck with my part of
many of my home duties which are way too heavy for her as well,
because of all the arthritis problems she has of her own. At times
she can hardly move. She often doesn’t sleep many hours in her bed
and have to move between the sofa and her bed. Her hands are also
swollen when she gets up in the morning.

Dr. Melissa Mercogliano of The Center for
Orthopedic and Lymphatic Physical Therapy, in Port
Orchard, http://colpt.com/mam.html is the
person who helped us a few years ago and taught my husband and me
how to properly wrap my legs. She is a fountain of patient
information and goes out of her way to inform and
educate.

The National Lymphedema Network is proud to
announce the establishment of the Lymph Notes Scholarship.

In the United States, access
to treatment is still a critical factor for many lymphedema
patients. Outside of major metropolitan areas, finding adequate
treatment continues to be a major obstacle to care.

To help address the need for increases access
to care, this annual scholarship, generously provided in honor of
Lymph Notes, will cover up to $1,000 tuition for a healthcare
professional to obtain specialty lymphedema training and
certification.

In answer to numerous comments and inquiries about breast
reduction, Cindy responds,

“Do the boob job. You will not regret it. I had some problems but I
do not regret it at all. I love my new body. The stress is gone
from my neck and back. I am sure there are Drs in Gig Harbor or
Tacoma. I had a friend recommend Mary Lee. I like recommendations.
I would highly recommend Mary Lee and her wonderful
staff.”cindydillion@yahoo.com

“Breast Reduction, Also known
as, breast reduction surgery removes excess breast fat, glandular
tissue and skin to achieve a breast size in proportion with your
body and to alleviate the discomfort associated with overly large
breasts.”

Some women are born with the genes to grow the
unwieldy, heavy huge breasts that can work to make their lives
challenging and think about surgery, but hesitate. Sometimes hesitate for years, a
lifetime.

Cindy Dillion, 62, finally
had enough earlier this year and determined to find a plastic
surgeon to remove the excess burden of her oversize breasts.

Cindy’s sister had breast reduction done 35
years ago. When the
doctor asked what bra size, she wanted to be she answered – her
only criteria – make breasts smaller and point my nipples, “nipples
pointed at the sky.”Thirty-five years
later, Cindy’s sister declares her nipples still “point at the
sky.”

Cindy’s body was marked before surgery –
sculpted according to her plastic surgeon artistic eye and
examination of the patients shape. No to the fancy
‘starburst’ nipple – just smaller, balanced
and each boob should be looking ahead. No pointy nipples.

Cindy lost five pounds off her breasts and
another four pounds off her body when they liposuctioned the fat
around her belly, shoulders and back.

In the six and a half weeks since the
operation, she has lost twenty-one pounds and got more than she
bargained for when her body rejected the stitches – she was
allergic to them. Ten
days post operation she developed an opening, by the twelfth day
the slight opening was open around the nipple and caused the drain
hole to shift. An
infection followed, leading to extraordinary effort from her long
time husband – the husband she now calls, “Rock
Star.”

The couple turned one of their empty nest
bedrooms into a spotlessly clean medical wound changing room where
twice a day Rock Star follows doctor’s orders, changing the
wrapping, and helping his wife heal through his devoted attention
to the wounds.

Cindy cannot bring herself to look at her
wounds, as her husband does, but noted she can now see her nipples
for the first time in fifteen years AND noted her active support
group had their “Boob Voyage” party and look
forward to the next one – the BraBeque
Party!
(burning of the old painful reminder bras)

Her bra size at the time of the operation was
42 K and Cindy guesses she may drop back to the 36 D-bra size she
has not seen in twenty-five years.

Cindy’s Seattle doctor is surgeon Mary
Lee Peters, M.D. I was impressed upon
learning the doctor did not ask what bra size Cindy wanted since,
it seems to me, a good plastic surgeon should be medically
artistic enough to take the patient’s body size and frame, in
consideration to make the judgment call for each
individual. Hip, hip
– hooray!

Insurance did not cover the
cost of Cindy’s Breast Reduction – their
deductible was too high and the out of pocket cost was
$13,000 .00 $9,000.00 for breasts
and $4,000.00 for the liposuction[S1].

Cindy healing into a new
size

[S1]Cindy Dillion
is a professional Realtor working out of
the Coldwell Banker Bain office in Gig
Harbor. She
will talk to anyone who has questions about one of the most
underrated medical procedures I know – surgery to
get relief from the pain and weight of oversize
breasts.

Ask your doctor…and look for a miracle
inhaler for some COPDers. The PATHOS
study published in the Journal of Internal
Medicine shows that SYMBICORTR TurbuhalerR
(budesonide/formoterol) must be some kind of miracle
inhaler for chronic obstructive pulmonary disease (COPD)
patients.

Among other advantages, the PATHOS study
showed a 26% decrease in exacerbations for moderate –
severe COPD!
The SymbicortSYMBICORTR
TurbuhalerR
inhaler has to be bliss for those COPDers able to use it.

I’ve used Foradil Aerolizer
(Formoterol Fumarate Inhalation Powder) for
years. The Fulmarate
ingredient seems to make it a relative of
SymbicortSYMBICORTR TurbuhalerR
and it is the single inhaler I take (of
three) that noticeably helps me breathe easier.

Best of all is the promise shown in the
PATHOS study:

“Dr. Kjell Larsson,
Professor of Respiratory Medicine at the
Karolinska

Institute in Stockholm said:
“So called ‘real world’ studies, such as

PATHOS, together with randomised prospective
studies, play an important role

in answering questions about the value of
medicines in delivering better,

cost-effective healthcare to patients. These
findings can help physicians

and the healthcare community to understand
disease patterns and create a

fuller picture of treatment effects and what
patients are experiencing.”

Lymphedema Remedial Exercise as a part of CDT
requires compression garments or bandages.3-5 There are no studies
on the use of compression garments when performing stretching or
flexibility exercise alone.

Our visiting young cousin from
Norway rode her first recumbent trike in Silverdale and wore “What
is COPD” tee shirt while she was here.

My young cousin, Malin from Norway is included here because
COPD (Chronic
Obstructive Pulmonary Disease) began in 1997 for me and led into my
long ride into medical conditions – one after the other and my
gathering weight attracted lymphedema as surely as fresh bread and
butter sticks to peanut butter and strawberry
jam.

“The NLN Medical Advisory
Committee (MAC) recommends using the guidelines for aerobic and
resistance exercise to guide use of compression during flexibility
exercise since flexibility exercises may be combined with other
forms of exercise.

The amount and type of compression for exercise should be decided
with input from a professional knowledgeable about lymphedema.
There is no strong evidence basis for the use of compression
garments during exercise; however, most experts in the field of
lymphedema advise the use of compression during vigorous exercise
for people with a confirmed diagnosis of lymphedema.

Melissa showing me the latest
fast, protective lower leg support

Melissa Mercogliano,
Center for Orthopedic
& Lymphatic Physical Therapy in Port Orchard,
WA.
recently showed me a new and easy way to add support stockings…easy
except for we Tub’ettes.

“One study suggested that individuals with lymphedema who do
resistance exercise without compression may increase
swelling.

20 Resistance exercise may reduce limb volume when used as an
adjunct to compression therapy in people with confirmed
lymphedema.

8 One study showed that aerobic and weight-lifting exercise was
safely performed without compression in women at risk for breast
cancer-related lymphedema.

9 That study showed patients who developed lymphedema could
continue to exercise with compression garments. Compression
garments should be measured by an individual trained and
experienced in fitting compression garments for lymphedema and
should be at least Class I compression for upper extremity. Higher
classes may be required for more severe lymphedema and for lower
extremity lymphedema.

Custom sized, each leg. This
pair is old…notice the crinkles below the rubber dotted band. The
replacement compression stockings are black.
This pair is about one year old.

I throw the stockings in a little zippered mesh cloth bag and into
the washer on a short cycle, regular soap, extra rinse – cold water
and smooth out and let them hang to dry.

I prefer the toe less stocking so my toes don’t get scrunched up
and have two different kinds. The little rubbery tips around the
tops of both help them from sliding on down my leg and cutting off
circulation. Ask your
doctor.

“A hand piece (gauntlet or glove) is recommended when exercising
with a sleeve to avoid causing or exacerbating hand
swelling.

Definition of Individuals At Risk for
Lymphedema:

Individuals at risk for lymphedema have not displayed signs and
symptoms of lymphedema but may have sustained damage to their
lymphatic systems through surgical lymph node removal or radiation
therapy.

Additionally, individuals at risk may have surgical incisions in
the vicinity of lymph transport vessels.

Individuals who have family members with hereditary lymphedema may
also be at risk.

An individual’s risk of lymphedema may change over time depending
on factors such as weight gain, age, and changes in medical
condition.

It is the position of the NLN that:•

Exercise
is a part of a healthy lifestyle and is essential for effective
lymphedema management•

Before starting any exercise program, individuals should be cleared
for the program of activity by their physician.•

Lymphedema Exercises
(also known as Remedial
Exercises) are specific rhythmic muscle and breathing exercises
used as a part of lymphedema treatment in Phase I and Phase
II

Complete Decongestive
Therapy (see the NLN Position Paper on Diagnosis and
Treatment).
http://www.lymphnet.org/pdfDocs/nlntreatment.pdf

In Phase II lymphedema
maintenance, these exercises can be combined with or integrated
into a regular exercise program.•

After intensive treatment with CDT, the person with lymphedema
should work with the certified lymphedema therapist or qualified
lymphedema specialist provider (MD, NP) to adapt their remedial
exercises into their fitness and weight management program at the
time they are moving from Phase I (treatment phase) to Phase II
(self-management).•

Individuals with or at risk for lymphedema can and should perform
aerobic and resistance exercise in a safe
manner.•

The individual with or at risk for lymphedema may benefit from
working with an Exercise
Physiologist and/or Personal Trainer. The person
with lymphedema should inquire if the trainer or exercise
physiologist has experience working with lymphedema and other
medical conditions. Certification for personal trainers varies.
Patients who are unsure of about the qualifications of a community
exercise practitioner should work with a certified lymphedema
therapist or health care provider to assist them in finding a
community exercise program or professional.•

In general, individuals with a confirmed diagnosis of lymphedema
should utilize compression garments or compression bandages during
exercise.•

Individuals at risk for lymphedema may or may not utilize
compression garments during exercise; this is an individual
decision to be made with guidance from a care provider and/or
therapist based on risk, activity, and conditioning
level.•

Individuals at risk for lymphedema will benefit from most forms of
exercise tailored to their individual needs.

•

Individuals at risk for or with a confirmed diagnosis of lymphedema
should avoid repetitive overuse of the affected part.
Sudden increase in an individual’s usual exercise duration or
intensity may trigger or worsen lymphedema. It is likely that a
program of slowly progressive exercise for the affected body part
will decrease the potential for common daily activities to result
in overuse.•

Exercise should be started gradually, increased cautiously, and
stopped for pain, increased swelling, or
discomfort.•

The risks of exercise for the individual with or at risk for
lymphedema must be balanced against the risks of deconditioning
that undoubtedly results from not exercising. A deconditioned body
part with or at risk for lymphedema can do progressively less
without risk of overuse. As a result, exercise is recommended for
those with and at risk for lymphedema.

•

The NLN cannot specifically determine the safety
of exercise for any individual. The guidelines in this Position
Paper provide general principles, but do not substitute for medical
evaluation and recommendations from a health care professional. It
is the responsibility of all individuals with or at risk for
lymphedema to consult with their health care provider regarding
their own specific needs.

I’d like to be part of a support group of fatties who NEED to lose
weight for their health’s sake – with or without current medical
issues. No dues – a scale and occasionally health professionals
willing to talk to us – to educate us – to motivate us – guest
speakers.

I have been told that I’m not a good candidate for bariatric
surgery…so, before I push that particular button – is there anyone
beside me, who wants to be part of an obese/tubby support group to
work together for weight loss and good health?

To lose weight through good nutrition and exercise is my
goal.

We are dying of too much fat, fellow Tubby Ones.

Will you join me in our battle to shed the fat and live healthy?
Let me know…

Dr. Halligan, surgeon, Doctor’s Clinic
Silverdale, saved my life/legs when he checked to see if
the deep lesions on my left leg could be treated without
surgery….and wanted a daily cleaning –debriding – and rewrapping of
the leg. The doctor ultimately did it himself – everyday in the
hospital.

Back home my husband, trained byDoctor’s Clinic Silverdale
took over the leg lymphedema wrap.

“Obesity may contribute to the development of
lymphedema, a small study showed.

Among 15 obese patients with enlargement of the legs, the average
body mass index was significantly greater for those with confirmed
lymphedema (70.1 versus 42.0 kg/m2, P<0.001), according to
Arin Greene, MD, of Children’s Hospital Boston,
and colleagues.

“Our findings suggest that obesity … may be a cause of
lower-extremity lymphedema,” they wrote in a letter to the editor
in the New England Journal of Medicine.

“As the amount of adipose tissue increases in the lower extremity,
lymphatic vessels may become dysfunctional (possibly because of
compression or inflammation), thereby reducing proximal lymphatic
flow,” they explained.

“Alternatively, elevated production of lymph from an enlarging limb
may overwhelm the capacity of a normal lymphatic system to remove
the fluid from the extremity,” they continued. “Although lymphedema
is typically progressive, we speculate that

http://www.medpagetoday.com/Endocrinology/Obesity/32986

Steven Gardner,
political reporter at the
Kitsap Sun,
will have
Bariatric surgery at Swedish Hospital in Seattle
probably in the April time frame.
Steven tells his story here:
http://fieldofsteve.com/

“Obesity is known to be a major lymphedema risk
factor” Part 3a of 3b

Fitness and Exercise:

It is very important for individuals with lymphedema to be
physically fit and maintain a healthy weight. A safe form of
exercise is an essential part of a fitness program for people with
lymphedema. Fitness and exercise are not the same. Exercise
includes many different types of physical movement. The three main
types of exercise are: aerobic, strength, and
flexibility.

These three types of exercise, along with Lymphedema Remedial
Exercises, are addressed

in this paper. There are many other types of exercise that have
health benefits such as Pilates, yoga, Tai Chi, Qigong, aquatic
exercise,1trampoline rebounding, breathing exercises, and
relaxation exercise that have not been adequately studied in people
with lymphedema. However, the person with lymphedema can use the
benefits of any system of exercise if he/she follows the general
safety principles of exercise with lymphedema, seeks medical
guidance, and uses caution in starting any new exercise
program.

Exercise and types of lymphedema:

Lymphedema has many causes. The type of exercise that is best for
an individual depends upon the severity and cause of lymphedema and
other co-existing medical conditions (e.g. heart disease, diabetes,
arthritis, etc).

Exercise for breast cancer-related lymphedema is the most studied
lymphedema condition. Many conclusions about exercise and
lymphedema are based on studies of breast cancer survivors that may
or may not apply to other forms of lymphedema.

Lymphedema Remedial Exercise:

Lymphedema Remedial Exercise is a part of treatment for lymphedema
when reduction of size of a limb is necessary. Lymphedema Remedial
Exercise involves active, repetitive, non-resistive motion of the
involved body part.

Exercise in Phase I and Phase II Complete Decongestive
Therapy (CDT) (see Position Paper “Diagnosis and
Treatment of Lymphedema”
http://www.lymphnet.org/pdfDocs/nlntreatment.pdf) is
performed with compression as an essential part of the total
(complete) reductive phase of lymphedema therapy.

3-5

Lymphedema exercises, used with compression, help the body’s
natural muscle pump to increase venous and lymphatic fluid return
to the circulatory system and out of the swollen areas. Remedial
Exercises for lymphedema are similar to some movements of low
impact Tai Chi and Qigong, but are different in that lymphedema
Remedial Exercise is used with Phase

I treatment of lymphedema to reduce size of the body
part.

Lymphedema Remedial Exercise has been studied and
shown to reduce limb swelling.3-5

It is unknown whether Lymphedema Remedial Exercise alone can
prevent

lymphedema in at-risk individuals, or whether they can maintain
reduction of swelling without compression.

Flexibility or Stretching Exercises:

Flexibility exercises include a wide range of activities that
stretch muscle and connective tissues to increase and/or preserve
range of motion. Flexibility exercises can minimize skin scarring
and joint contractures that may lessen lymph flow. Flexibility
exercises should be performed slowly and progressed gradually.
Flexibility exercises are not a treatment for lymphedema, but are a
part of optimal lifestyle management for reducing the complications
of lymphedema. Lymphedema has a tendency to restrict motion of
muscles and joints.

Optimal lymphatic function requires full mobility of muscles and
joints. Lymphedema from cancer treatment can be associated with
tight muscles and connective tissues due to fibrous adhesions from
surgery or radiation. Tight muscles and scars from surgery or
radiation may require Physical or Occupational Therapy to treat
before attempting to do self-stretching.

Specific stretching exercises for cancer treatment-related scars
and joint restrictions in an area at risk of lymphedema should be
prescribed by a provider familiar with the management of
lymphedema. A specialized form of stretching exercise may be
required for Axillary Web Syndrome (AWS) or
axillary cording, a condition that can occur in cancer survivors
who have had axillary (armpit) lymph nodes removed.6

AWS may benefit from treatment by a certified lymphedema therapist
and specific home stretches taught by a therapist.7

Resistance exercises can be performed without moving a joint
(isometric) or by moving the joint through a range of motion
(isotonic). All of these types of resistance exercise may be
utilized by individuals with lymphedema, but should be done
cautiously, starting with low weights, low repetitions, and gradual
progression. Resistance exercises are performed against an
opposing load to enhance muscle power, stamina, and tone.
Resistance exercise may reduce limb volume when used as an adjunct
to compression therapy8

One study showed that guided participation in resistance exercise,
as a part of a total fitness program, did not increase the risk of
developing lymphedema in breast cancer patients
at risk over the group who did not exercise.9

Lymphedema did occur in both groups. No increase in lymphedema
development was noted between the exercise and the non-exercise
group. There have been many studies on resistance exercise in
breast cancer-related lymphedema that show no harmful effect on
lymphedema and beneficial effects for overall
health.10-20

Aerobic Conditioning or Cardiopulmonary
Exercise:

Aerobic conditioning exercise is often referred to as “cardio”
exercise. Aerobic exercise involves activity that uses large muscle
groups to increase the heart rate to 60-70% of an individual’s
maximum heart rate. This type of exercise, when progressed
gradually, increases the heart and lung capacity while also
improving muscle conditioning.

Aerobic conditioning enhances cardiovascular fitness, effective
weight management, and overall health and well-being, all of which
are very beneficial to people with lymphedema from all
causes.10-21

Walking, jogging, cycling, and swimming are examples of aerobic
conditioning exercise. Aerobic conditioning has not been studied
formally as a treatment for lymphedema. One study showed no adverse
effect on lymphedema from aerobic exercise.17

Resistance Exercise plus Aerobic Exercise:

Studies of combined resistance and aerobic exercise have shown no
adverse effects on lymphedema.21

No studies have specifically evaluated resistance plus aerobic
exercise as a stand-alone treatment for lymphedema. One study in
breast cancer-related lymphedema showed that the individuals who
performed aerobic conditioning and weight lifting had better
control of their lymphedema and had fewer flares of lymphedema than
those who did not exercise. However, individuals with lymphedema
still had to utilize standard lymphedema therapy techniques
for
flares.

Another study about women at risk for breast cancer-related
lymphedema showed that aerobic conditioning and
weight-lifting reduced the risk of developing
lymphedema.

Considerations for Designing an Exercise
Program:

A number of studies have shown that aerobic and resistance
exercises are safe and beneficial for people with lymphedema or at
risk of lymphedema if they follow the guidelines for progressing
slowly, use recommended compression, and report any adverse effects
to a professional who can help them adapt their exercise
regimen.9,16-21

Most studies on lymphedema and exercise have been done on breast
cancer survivors, but the principles may guide exercise in other
forms of lymphedema. Individuals with or at risk of lymphedema must
report other health conditions that need to be considered in
developing a personal exercise regimen (diabetes, heart disease,
neuropathy, arthritis, etc).

Modifications of aerobic and resistance exercise that are commonly
recommended for individuals with lymphedema are:

1) Allowing adequate rest intervals between sets; 2) Avoiding
weights that wrap
tightly around an extremity or clothing that cause constriction; 3)
Wearing compression sleeves or bandages during exercise; 4)
Maintaining hydration; 5) Avoiding extreme heat or overheating; 6)
Exercising in a circuit that alters the type of exercise and body
part within the exercise session.

Exercise and Compression Garments:

Lymphedema Remedial Exercise as a part of CDT
requires compression garments or bandages.3-5 There are no studies
on the use of compression garments when performing stretching or
flexibility exercise alone.

Gradually build up the duration and intensity of any activity or
exercise. Review the Exercise Position Paper.

•

Take frequent rest periods during activity to allow for limb
recovery.

•

Monitor the extremity during and after activity for any change in
size, shape, tissue, texture, soreness, heaviness or
firmness.

•

Maintain optimal weight. Obesity is known to be a major lymphedema
risk factor.

III.
Avoid Limb Constriction•

If possible, avoid having blood pressure taken on the at-risk
extremity, especially repetitive pumping.

•

Wear non-constrictive jewelry and clothing.

•

Avoid carrying a heavy bag or purse over the at risk or
lymphedematous extremity.

IV. Compression Garments should be well-fitting.

•

Support the at-risk limb with a compression garment for strenuous
activity (i.e. weight lifting, prolonged standing, and running)
except in patients with open wounds or with poor circulation in the
at-risk limb.

•

Patients with lymphedema should consider wearing a well-fitting
compression garment for air travel. The NLN cannot specifically
recommend compression garments for prophylaxis in at-risk
patients.”

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In part 3, I’ll show you the two kinds of leg support
stockings I use and why I like them. There are many other
support stockings out there – ask your doctor what she/he
recommends. Also, I’ll show you several tools that aid in
putting them on.

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About This Blog

This is a patient to patient blog to exchange information and resources...from COPD (Chronic Obstructive Pulmonary Disease) to Arthritis to Cellulites to Sarcoidosis to Sleep Apnea to RLS to Psoriasis to Support Groups to Caregivers and all points in between. Written by Sharon O'Hara.